Not Coming Soon: The Pill for Men

Editor, UK

A male contraceptive pill might be more and more feasible, but don’t expect to see it in pharmacies any time soon. A study published yesterday in the scientific journal PNAS described a new form of male contraception successfully tested on mice, which has led to many hailing an imminent "male pill." But guys, we’ve been here before. Manytimes.

The idea of a male pill has been around for a while, and it’s a very attractive one. As it stands, women have a whole range of contraceptive options, from pills to implants, patches, diaphragms, and other more scary-sounding devices. Men are pretty much stuck with condoms or vasectomies. A male pill would offer men a new way to control their role in baby-making.

It would also take some of the contraceptive burden off women. After all, the female pill has an unappealing array of potential side effects including weight gain, weird periods, nausea, and mood changes. When you’re taking the pill every day, those kind of hormonal reactions can be a real downer. Having a male alternative wouldn’t (and shouldn’t) replace the female pill—that would put a woman’s decision over her fertility in a man’s hands, and undo everything the pill did for women's liberation in the first place—but it would give couples more options to share the responsibility for contraception and pregnancy (yay for equality).

This latest solution is different from most other proposals as it works by preventing sperm from traveling from the testes to the penis; basically, they stay in storage even during the most climactic of sex scenes. Killing the action there gets around the challenge of deactivating every single sperm cell that might make its way to an egg, of which there are millions. The Australian and British scientists behind the study did this by blocking two proteins in the muscle cells that “launch” the sperm in ejaculation, a process they called “double knockout.”

“This modification produced 100 percent infertility without effects on sexual behavior or function,” they wrote. “Futhermore, double knockout sperm were capable of producing normal offspring following intracytoplasmic sperm injection into wild-type ova and implantation of the fertilised eggs into foster mothers.” That’s good—there’s no way a male pill would ever take off if it affected a man’s ability to have sex or his long-term fertility. Even better, as it’s not a hormonal solution it doesn't come with all the mood-killing side effects of the female version. As the authors explained, “Historically, most therapeutic targets have been hormonal and therefore likely to have intolerable sexual, behavioral, physiological, and psychological side effects.”

Of course, this is very early stage research. The study was on mice, not humans, and they were genetically engineered to have the relevant proteins knocked out. While the authors said that a drug could theoretically suppress the proteins, the paper is for now just a proof of concept. And even though it could be an important scientific step toward the development of the pill, science is far from the only barrier when it comes to developing male birth control.

The fact is, big pharma just doesn’t seem to be interested. They don’t think there’s money in a male pill. That doesn't necessarily reflect a lack of demand—a 2005 study found that over 55 percent of men accepted the idea of hormonal “male fertility control,” which would mean a lot of potential customers. But there are other barriers that could be holding back drug companies from investing in male contraception.

It’s something Carl Djerassi, the “father” of the female pill, has recognised for a long time. A self-declared feminist, he wrote in an essay in Wired earlier this year that scientists already know how to create a male pill, but that economics are standing in the way. He explained that a major problem is the length of time a man remains fertile, which is over twice that of women:

“A young woman will not ask whether continued use of her Pill would affect her fertility at 45 or 50, whereas many 20-year-old men would require a guaranteed answer. To provide an epidemiologically valid answer to a young man would be expensive, time-consuming (thus cannibalising most of the potential patent life) and open to lawsuits, since men may blame their Pill for age-related erectile dysfunction and prostate-gland problems.”

The costs of testing a male pill and the lack of patent potential, coupled with the risk of lawsuits, make the male pill a double-knockout for drug companies, and without them onboard, it's unlikely the idea will ever become a widespread reality. When it comes to the male reproductive system, all efforts are focused where the money is: preventing impotence and improving performance. Until those priorities change, we'll keep seeing stories about male pills that are just a few years away, but they'll remain just stories. In short, it looks like we won’t be having male contraceptive-induced apocalyptic orgies any time soon.

That's unless, of course, we forgo pills altogether and just sterilize ourselves after freezing a few gametes for later. That’s the future Djerassi painted in an interview with the Daily Mailtwo years ago, when he said that in the next 20 years, young people will “do away with the need for contraception by being sterilised, and withdraw their eggs and sperm from the bank when they are ready to have a child via IVF.”

So perhaps there'll be no demand for a male pill soon, anyway. If the contraceptives of the present give us sex without babies, the birth control of the future gives us babies without sex.